Abdominal contouring is commonly done using liposuction. Most of the time this is fat debulking or overall volume reduction to get rid of larger volumes of fat. But in thinner patients, almost always men, they desire a more refined type of liposuction described more appropriately as liposculpture. This is the removal of smaller amounts of fat that are bothersome to the more athletic or thinner body frame patient.
One unique type of abdominal liposculpture is that of abdominal etching. Often called ‘six-pack’ surgery, this is a liposuction technique that creates linear lines to create the appearance of cut abs. This is usually a midline vertical line and several (usually three) horizontal lines. In essence these are artificially created anatomic replicas of the underlying abdominal wall inscriptions. While it may be called cheating by some, it can be an effective surgical technique in the properly selected patient.
Abdominal etching is a small cannula linear liposuction technique that achieves its result by creating a dermal-fascial adhesion. By removing the fat that lies between the skin and the abdominal wall, indentations or grooves are created in the overlying abdominal skin. To help hold the initial linear lines that are created by the etching method, I like to use linear strips of compressible foam along the newly created etch lines applied right after the problem. When a wrap around abdominal binder is applied circumferentially, it helps push the skin down in the fat removed lines and prevent fluid from building up under them. The patient keeps the foam strips on with the binder for two days after the procedure when they can be removed.
Abdominal etching works best in thinner patients and, although it is not really ‘natural’, looks best when it is not overdone with lines that go beyond the locations of the actual abdominal inscriptions. But no matte how they are made, they will not appear at all or will be very shallow if the fat removed under the lines fills with fluid and does not scar down properly. This strip foam dressing method is one technique that I have found useful in abdominal etching that adds no expense or extra effort for the patient.
Dr. Barry Eppley
Indianapolis, Indiana